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. 2022 Jul 13;17(7):e0271175.
doi: 10.1371/journal.pone.0271175. eCollection 2022.

Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

Marieke B J Toffolo  1   2 , Jamie R Fehribach  1   2 , Chris P B J van Klaveren  3   4 , Ilja Cornelisz  3   4 , Annemieke van Straten  1   2 , Jean-Louis van Gelder  5   6 , Tara Donker  1   2   7
Affiliations

Automated app-based augmented reality cognitive behavioral therapy for spider phobia: Study protocol for a randomized controlled trial

Marieke B J Toffolo et al. PLoS One. .

Abstract

Background: Fear of spiders, or Arachnophobia, is one of the most common specific phobias. The gold standard treatment, in vivo exposure therapy, is effective, but comes with significant limitations, including restricted availability, high costs, and high refusal rates. Novel technologies, such as augmented reality, may help to overcome these limitations and make Exposure Therapy more accessible by using mobile devices.

Objective: This study will use a Randomized Controlled Trial design to investigate whether ZeroPhobia: Arachnophobia, a 6-week Augmented Reality Exposure Therapy smartphone self-help application, can effectively reduce spider phobia symptoms. Additionally, we will examine user-friendliness of the application and the effect of usage intensity and presence on treatment outcome.

Methods: This study is registered in the Netherlands Trial Registry under NL70238.029.19 (Trial NL9221). Ethical approval was received on October 11, 2019. One-hundred-twelve participants (age 18-64, score ≥ 59) on the Fear of Spiders Questionnaire [FSQ] will be recruited from the general Dutch population and randomly assigned to a treatment or waitlist control group. The ZeroPhobia application can be accessed on users' smartphone. Baseline, post-test (i.e., at six weeks), 3- and 12-month follow-up assessments will be done, each including the Fear of Spiders Questionnaire as the main outcome measure as well as additional measures of anxiety, depression, user-friendliness, and presence as secondary measures and covariates.

Results: The study was funded on September 25, 2018. Data collection started in September 2021 and the study is expected to run until September 2022.

Conclusions: Our study will improve our understanding of the efficacy and feasibility of providing Exposure Therapy for spider phobia using an Augmented Reality self-help application, with the intention of making mental health care more accessible.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: TD and JLvG have developed the ZeroPhobia application, which is used in the present study in collaboration with Vrije Universiteit. ZeroPhobia is intended for commercial release. Hence, TD and JLvG will not be involved in data analysis or with any decisions related to the publication of findings. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The other authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) schedule of enrollment, interventions, and assessments.
Fig 2
Fig 2. Participant flow chart.
Fig 3
Fig 3. Home screen (see Table 1 for translations of the module’s names).
Fig 4
Fig 4. Screenshots of (1) animated therapist and (2) pet spider.
Fig 5
Fig 5. Spider selection screen.
Fig 6
Fig 6. AR spiders: (1) Cross spider, (2) Wolf Spider, (3) Barn Funnel Weaver, (4) Tarantula.
See this image and copyright information in PMC

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